Today in Health IT Auto, G P T hymns and the end of the PhD and more. We're just gonna run through the news. My name is Bill Russell. I'm a former c o for a 16 hospital system and creator of this week health, A set of channels dedicated to keeping health IT staff current. And engaged. We wanna thank our show sponsors who are investing in developing the next generation of health leaders.

Sure. Test and Artis site. Check them out at this week, health.com/today having a child with cancer, one of the most painful, difficult situations. A family can face in 2023. We've partnered with Alex's Lemonade stand, as you know, to celebrate our five year anniversary. And we have a goal to raise $50,000 of which we've already raised, 29,000.

, we would ask you to join us in this drive. , hit our website. Top banner. You'll see the logo for Alex's Lemonade stand. Go ahead and click on that and give Today. You can also see us at hymns. We are doing another Drive, captain's Cures for Childhood Cancer. , I'd love to get your picture taken with Captain.

Post that to social media tag this week. Health, everyone in the picture, we give $1 towards childhood cancer. We raise 16,500 at the Vibe Conference. Love to do the same at the Hymns conference. We believe in the generosity of our community and we thank you in advance. All right, today, , today's an interesting day.

Let's. Have a bunch of stories I want to get through there. There's just a bunch of stuff going on. So, , I'm gonna start with the trendy. I'll start with auto. G G P T. If you haven't seen auto, G P T, it's interesting, it's a layering of, , of chat G P T commands with memory. Okay? So look it up on YouTube.

Worth taking a look at. It is, , it's autonomous. G P. Essentially think of it that way. And so you install a couple of things on your, , computer, , you tap g p T into Pine Cone and then you can, , name. Your auto automation robot, if you will, and then give it a task. And the reason it's called auto g p t is because it will start to try to solve that task.

And if you put it in an autonomous mode, it'll just do it on its own and it will start to, , spawn different, , instances of chat c p t and it'll just go on its own worth taking a look. If nothing else to get you thinking of what the possibility is here. , you know, I could give you, there's a couple of examples of what people have done.

They've done crazy things like. , start a business and make me money. Here's the five goals, and then it starts going out. The other thing it does is it goes out and actually looks at websites, consumes those websites, puts it into GP t's memory, and allows you to ask questions based on that. So, , you know, start a company, raise money.

It'll go out, find, , it'll Google. You know, starting a business, what are the best businesses? , if you give it a goal that says, Hey, I want as little, , interaction as possible, I want it to be an autonomous business. It'll find some sort of business that does affiliate marketing or partners with, , drop shipping companies to sell Amazon goods and that kind of stuff.

, but you could think about it being used in other ways, in other areas. I've seen it used for SEO where it's constantly working to develop better and better content for search engine optimization. , I, you know, I'm trying to think what the. Use case is for healthcare. It's a little early in the morning for me to come up with that.

I know that within it, it would be interesting to get this thing on a, a constant loop of consuming certain amount, certain amount of content, and producing something. If you have, , something you pr, , give to a. A person or a department and say, you know, go through this massive trove of information and find this or that kinda stuff.

Anything that's manual in nature in that way, , auto G p t would be pretty interesting. All right. We also have the end of the public health emergency and couple things get signed and that is moving forward. I think the big takeaway there is that, , better times are not ahead for health systems. , I think the most impactful thing of the end of the p e is Medicaid redetermination and moving around of, , essentially during, during the, , pandemic and as a result of some legislation that was passed, , or that was part of the PhD.

, people could not be taken off the roles of Medicaid. And now that the PhD is over, those people can be taken off the roles of Medicaid if they do not, , essentially meet the criteria for Medicaid. So Medicaid redetermination is the name for moving all these people off the roles who potentially no longer qualify for.

, that will lead to potentially, , more charity care, more care that's not paid for in the emergency room. And, , a couple other things. So there's, there's a lot of fear within the industry that this will lead to, , essentially less money in the system for healthcare, , organizations. , not only that, there, there was money in the PhD and, , some allowances in the p.

That, , will potentially go away. Now, some of them have been protected as we talked about earlier, , by the budget and other things. So it's not like all the things that we're in the PhD are going away immediately. There's, there's some telehealth stuff that's been protected. There's , also some codes that have been protected.

So, , we will continue to sort of have a soft landing on this, but it's not like, It's not like there's more, , more money coming into the system. There's less money in the, the system. , let's see. , oh, yeah, let me hit this one. So ONC proposes new rules for cures Act, implementation, certifications and more.

, according to the ONC, some key proposals. In the mprm, and by the way, this is, this is put out as a new rule, which means you're gonna have a comment period and all this other stuff we're taking a look at. So this is according to the ONC making the Electronic Health record Reporting program a new condition of certification for developers of certified health.

It expanding and modifying exceptions to information blocking regulations to support wider information sharing. Hmm. Expanding and modifying exceptions. Interesting. , revising some certification criteria including rules and clinical decision support, patient demographics and observation, electronic case reporting and APIs for patient population services.

Let's see, going on adopting the version three of the United States, , US CDI as a standard with NOC certification program and establish. And expiration date for U S C D I, version one as a certificate certification standard for the program, and updating some standards and implementation specs adopted under the CER certification program to advance interoperability, sport enhanced health, IT functionality and reduced burden, , burden of cost.

All right, so this is in place. I'm meaning, , meaning the interoperability rules in place for 24th century cures. , there's some carrots, there's some sticks, and now they are starting to fine tune it. They're trying to, again, the goal is interoperability, right? It is cures, it is the movement of data in pursuit and support of cures.

, I would not stand in the way this, in any way, shape, or. If I were a health system leader, I would understand what this means. I would have the right people, , giving me the information I need to understand what this means. I would have my team working on this. This is good for your community. Having the information move around.

And yes, there's gonna be people within your house system that are like, oh, that's not work. We have to do. It is work you have to do. That's number one. Number two, it's work that's good for your community and good for the people in your community. So I would absolutely be doing this. , I would be pushing my vendors to, , comply with this.

And so that just. , it just goes without saying that I would be, , pushing this, pushing this forward. , there's a lot of great articles. I'll probably come back and do some of these. , Eric Topo wrote one on generative ai. And the new medical generalist. I think that's an interesting story. I'll come back to that.

Cigna, , physicians deny claims on mass without reading them. This is a ProPublica report. This was done a while ago, but as I read this, it's just, , kind of horrific. Cigna physicians deny large batches of claims without reviewing them first. And by the way, this is ProPublica doing a expose if you. And so they deny 'em on mass a process that may save the company millions of dollars every year when members don't appeal.

ProPublica reported in March 25th, according to the report, an internal claim system at Cigna allows medical, , directors to deny a claim without opening the patient's file. , the report claims that Cigna physicians denied more than 300,000 claims over two months in 2022 through the system, which equated to 1.2 seconds of review per claim on average.

We literally click and submit. A former Cigna physician told ProPublica it takes all of 10 seconds to do so. , and they do 50 at a. Many states require medical directors, review patient files and coverage policies before denying claims. So there's a couple things I take away from this. One is, as a patient, most of the stuff I take away as a patient, one is a patient.

, it's worth, you know, going back and pursuing this stuff, , especially if you're a Sigma client, it would appear, I would pursue this stuff. Don't assume because something got turned down the first time. It's not valid. , there are obviously some, , some automations and some potentially policies. I'm not, I'm not ascribing, , malice to all payers, but I will say that, , you know, you could end up implementing an automation that does something to this effect that, , isn't really malice.

It's more around product. , regardless, I would, , I'd be vigilant. I'd also be vigilant in the, , coding if I want to see a doctor today. , you know, they're denying things based on coding. I would make sure the doctor's using, , the best coding in order to, , essentially make sure that, , my ailment, whatever that is, is covered.

, It's something that, , is really important and, , worth looking at. Let's see. Anything else? Let, let's talk a little bit about hymns. I'll talk more about hymns next week. , got my plane tickets heading up to Chicago next week and, , I was looking at some of the presentations they look. You know, look good, , some of the people who are going and whatnot.

So there, there's, it's interesting hymns, hymns is carving out a different place. So hymns, , used to be the place you went for a lot of different things and this is how it got up to be, you know, got to be 60,000 some odd people there. And it was a place where, you know, it was the intersection of technology and he.

Just like this show, it was, , the people who listened to this show, , were all going to be there. , and that's when it was aligned with, with chime. Chime has effectively with its partnership with health and putting the Vibe Conference, , opposite of this. They've effectively, , garnered that, , really two spaces.

One is the innovation space because they started with the money, right? So they started with the VC private equity people and said, this is the place you want to be, , for innovative companies and innovative solutions around healthcare. And, , and they put on a great conference. And so those people went there.

And then the second thing they started really, they court, they, , courted the people that were associated with Chime. First year, the conference was kind of like two conferences near each other, A chime spring forum and the five conference. And this year they decided to make it one conference and really the chime spring forum sort of.

To the, , to the background. And it was more of a five conference that also had chime attendees at it, and that's where a lot of the CHIME attendees went. That's where a lot of the, the it, the health it. So you, you now have the innovative health. , tech, , people and digital people at that conference.

You also have the, , healthcare IT people at that conference. And so they carved off that little niche, if you will, for themselves. , and so a lot of those people aren't going to the HEMS conference. However, the HEMS Conference is loaded. It's big. , there's gonna be a lot of people there, so who's going there?

One of the things that HS has done pretty effectively is build out a regional network of, , hymns chapter. And those hymns chapters serve not only the technology folks, but also serve, , the nursing officers, the CNIs, CMIOs, and others. And so you'll see, , a lot more of a clinical bent. At hymns, then you would see, , well, I'm not saying then you would see somewhere else, but you'll, you'll see a lot more of a clinical bent.

You're, you'll see, , a nursing program. You'll see, , I don't know, a lot of technologies that you wouldn't necessarily see at the five conference. You'll see beds and, , equipment that that goes into the, , into the patient rooms and whatnot. So you'll just see a lot. , clinically oriented things than you would see at say, the Vibe Conference, but it's not just vibe and hymns.

By the way, this has been a wild, wild, wild, , conference season because you went, you went Vibe, which really kicked it off to Becker's, to Scottsdale Institute, to hymns and hymns overlaps. With the, , , gosh, I'm, I'm forgetting the name of it. It's like the innovation conference out in Laguna Beach, but there's, there's just so many things going on.

It is just, , nuts. How many conferences just happened over the course of about three or four weeks. And clearly as a healthcare leader and executives, you can't go to. And I saw a bunch of people did go to Vive and then went to Becker's. I don't expect to see them at the Scottsdale Institute or the , , or, or at hymns.

And if my informal polling is accurate, we will not see that many CIOs at hens unless they've been asked. And the question is, you know, if they've been asked to speak, will they spend any time in hymns? And the answer I'm getting to that is no. I'm flying in. I'm flying out. , now there are some, , that see value and it's almost the same value you get every year at hymns, which is all of your partners are at one conference.

, and so you can go there, you can then meet with a bunch of the executives and a bunch of. , partners that you have. That's what I used it for. It was pretty effective that way. The, the training and the learning is interesting, but it had gotten so big that, , I wasn't able to go up and ask questions or interact with, , the leaders who had put that training together.

I, I still appreciated it. I took a lot of the presentations back to my team and whatnot. So, , anyway, heading to hymns next week, what do I expect? I expect. More of the same conversations, , you know, difficult time in healthcare. We're making progress, we're making progress in terms of integrating ai, , computer vision.

We're making progress in terms of, , workflows. That are more effective, bringing better quality, , bringing better access to care. , we're gonna hear, , things around mental health and the movement around mental health. We're gonna hear things around health equities, and so, , I think it will be an interesting conference.

I think there will be some really interesting keynotes and, , conversations. We will be there. , we will do our normal, , interview. Interview and action. And we'll try to do 10 to 15 minute interviews and you know, we're just gonna go with the flow. If the CIOs aren't there for interviews, what we're gonna do is we will find the CIOs and the CMOs and others who are there, have conversations with them, bring them to you on the, , conference channel.

So, let's see. Anything else I want to cover? No, that's not, that's a, that's a lot. So auto, G P T, Hy. The end of the public health emergency, , the ONC proposal around the Cures Act. That's probably enough for a Thursday morning. And then, , tomorrow I'll riff a little bit, , about some things and, , then we're off to Chicago.

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